Sunday, August 24, 2008

On Being Better Patients—The Follow Up

My last post on how to be better patients to each other stirred up some conversation—turns out (once again) that despite differences in diseases and symptoms, many things unite us, especially when it comes to waiting rooms, hospitals, and emotionally-charged situations.

As a follow-up to that conversation, I want to explore an issue one of my readers brought up in the comments section, something I touched on very briefly in the post—the idea of illness as a competition. “Illness isn’t a competitive sport” is the exact phrase that comes to my mind, and until very recently, I wondered how widespread the phenomenon was. Was it a dirty little secret of life with chronic illness, something that occurred in waiting rooms across the country? Or was it something more unique to the particular doctor’s offices I frequented? Judging from the initial response, I suspect the former is the case.

You know what I’m talking about, right? You’re sitting in your chair, perhaps leafing through a magazine or engaging in idle conversation with other patients in the room. Somehow the conversation around you turns into a bizarre sort of one-up-man-ship, with patients swapping war stories, surgery tales, and escalating degrees of complaints. The tenor has changed from surface-level camaraderie to a competition.

It’s an interesting phenomenon. I’ve never seen it get to the point where there’s almost a fight over whose symptoms are the worst, as others have mentioned, but I have seen it get pretty intense. Most times I ignore it, but sometimes it gets to me and I cannot wait to be called back just so I don’t have to hear it. It’s stressful to sit there and listen to so many things that are wrong. After all, everyone’s got something, or none of us would be there.

My reaction has always been, who would ever want to win the “sick” competition? That just doesn’t seem appealing to me, or worth it, or in any way productive. And I have to believe that no one really does want that title.

Obviously illness can be really isolating, so maybe people are just lonely and need some place to vent. Maybe they’re in a tough phase of acceptance or adjustment and their symptoms are especially overwhelming. Maybe their illness is a huge part of their identity and in the moment, someone else’s condition is somehow a threat to that identity. Who knows. But I don’t believe there’s any maliciousness or mean-spiritedness in it, and I don’t think it’s even an intentional escalation or competition.

And I think it’s just normal human nature to hear something and think, “You think that’s bad, how about X?” I know when I’m at my rheumatologist (which, for whatever reason, is where it happens the most) and listen to the back and forth I sometimes think about someone I know who’s had multiple major (invasive) surgeries and excruciating, degenerating pain and think these people are actually pretty lucky.

And clearly that’s not fair of me. Other people’s pain and illness are still very real and altering even if they don’t seem as severe as someone else’s. (And I say “seem” because really, you never know what someone else life or situation is truly like.)

At the same time, I’ve also felt funny even coughing at my lung specialist’s because I know there are some seriously sick people treated there, people waiting for transplants to save their lives, people who cannot live without constant oxygen, people I know are so much sicker than me. (They’ve never made me feel that way—most don’t even talk, it’s just a self-consciousness I feel).

And that’s not fair either, because this isn’t a competition and no one need apologize for not being as sick.

And I think the reason both those instances aren’t fair is what I will call Rule #7—No one has a market on suffering. Especially when we're at the doctors, and we're probably all a little anxious, and no one's feeling all that well.

Especially when you consider the saying posted over on Hemodynamics:
"Be kind, for everyone you meet is fighting their battle too."

Whaddya think?


Anonymous said...

The quote in the last line of your post made me think of a quote I often have running through my head.

The quote is:

"Have compassion for everyone you meet even if they don't want it. What seems conceit, bad manners, or cynicism is always a sign of things no ears have heard, no eyes have seen. You do not know what wars are going on down there where the spirit meets the bone."
--Miller Williams, Ways We Touch

Laurie said...

Hi Ashley,

Great quote, and very fitting! Thanks for posting.

Leslie said...

I think this is a great post! I definitely agree with you that it is kind of sickening to think that people do compete - because as you say, why is that a competition anyone would want to win?

I think, though, when it comes to invisible illnesses, it is easy for people to dismiss us as not really being sick and easy for us to become defensive and want to prove in some tangible way that we are the way we say we are. I know that isn't competing with other patients, but I think it is along the same lines.

I also wonder with the whole competition thing, where we draw the line? Would anyone ever empathize with anyone else? Who would deserve help and sympathy? In some ways, I think patient-patient competition breeds a lack of empathy. And as you also said, everyone has their own problems. We might not view them as being the same degree or kind as our own, but they still deserve support and understanding.

Unknown said...

Everything you said is SO true.
Maybe its something inherent in this country? When I received somewhat medical emergency treatment overseas (in the middle east), everyone I met in the waiting room did nothing but listen and wish me well. there was never one-upsmanship. between anyone.
thanks for bringing this to the forefront of the conversation, Laurie! I think you struck a very nice nerve here :-)

MJ said...

I haven't come across this in doctors' offices so much as I have at work. There is one guy in particular who always tries to "one up" anyone else's medical complaints. It's really awful, not only because no one wants to hear that, but it destroys any empathy anyone has on my team for anyone else. It's one of the main reasons I do not talk about my chronic Migraines, ever, to anyone at work (other than my boss out of necessity). I made the mistake of trying to describe what a Migraine feels like to one of my coworkers once, and this guy overheard us. Now he likes to use my description to describe his headaches (which are not Migraines). It really, really gets under my skin. And I don't understand why it's so important for him to be the sickest one of all.

Be well,

Anonymous said...

Hi Laurie, This is a new concept to me "illness competition". I have had little experience with this, though I have quite a bit of contact with other's who are also chronically ill.

The isolation and loneliness of living with disabling chronic illness can be severe. I imagine for many who have little human contact or support, the doctors office waiting room must look like a warm, friendly place filled with people that just might understand what they live.

Perhaps if someone is listing off ailments, it isn't that they are trying to compete, but actually are trying to connect with someone, who since they are also at the doctor's office, might be in a similar situation to their own.

Laurie, I enjoy the "food for thought" you pack into every post! Kerry

Anonymous said...

Laurie, first off, your book is awesome. I am 40something, and although I have been through some things (age related things) there is a language of pain and suffering regardless of age.

my best friend of 30some years had this conversation w/me once I became ill with SOD/pancreatic issues. I quite honestly was dumbfounded. I never thought of this as any competition. I only wanted her shoulder to lean on.

I even took the correspondence to my therapist as I was totally blown away with where the friendship had gone, and she confirmed that my friend had turned this into a competition (she has long suffered back/neck pain which included 2 discs replaced).

Of course, you don't know me, but I don't even like sports so competition is a foreign concept to me. My therapists suggestion was to walk away from the friendship, which I have done. It was extremely hard, but at this point in my life, I need positive enforcement.

My husband, who is dislexic and has a difficult time reading throroughly enjoyed the areas I marked for him corresponding to dealing with relationships and illness. Even after being with someone for so many years (been friends since we were 12), nothing prepares you for being sick and living in love with someone who is sick.

Bless you on such a great accomplishment with your book. It's going through our support group like wild fire (for pancreatic/sphincter of oddi dysfunction).

Hugggs, San

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